Chronic Pain Management

GENERAL INFORMATION:

What is chronic pain?

• Chronic pain is pain that persists or grows worse over a long period of time. Pain is an unpleasant feeling and emotional experience from injury or damage to your body. It may be a sign that there is a problem in an organ or tissue of the body. The body contains special cells that receive signals when there is damage or injury to the body. These cells send a message to the brain. When the brain receives the message, you feel pain.
  
  
• Chronic pain may last for months or years due to a chronic (long term) condition. It may be pain that remains after the usual recovery time following injury or illness. Chronic pain may persist even if caregivers have given you medicines or treatments. It may not be constant (always present) but still may cause problems with your daily activities. With chronic pain, you may feel depressed or hopeless. You may lose your appetite, or have trouble sleeping. Diagnosing and treating chronic pain as soon as possible may help you enjoy your life more.

What causes chronic pain? Chronic pain is often caused by more than one problem. These problems may include damage to the nerves or tissues, such as skin, muscles, and organs. there may be no clear or exact cause of chronic pain. Any of the following may cause or trigger chronic pain:

• Long-term diseases, such as cancer, arthritis, migraines, and back problems.
  
  
• Hormonal changes.
  
  
• Physical injury, such as after surgery or accidents.
  
  
• Problems with the chemicals in the body that send pain messages to and from the brain.

How is chronic pain diagnosed? It may be easier to diagnose your chronic pain if you have a pain diary. A pain diary helps track pain cycles, and make you more aware of when and how the pain may start and end. No tests are available to diagnose chronic pain. Caregivers may first look for possible causes of your chronic pain. The diagnosis of chronic pain is based on low long and how often you have your symptoms. Your caregiver will look for painful areas during a physical exam. He may touch, press, or stroke different sites or points on your body. You may also need any of the following to check how much pain you have or find its cause:

• Imaging tests: You may need imaging tests to look for the cause of your chronic pain. These may include x-rays, a computed tomography (CT) scan, and an magnetic resonance imaging (MRI).
  
  
• Pain scales: These are special tools that can help caregivers measure how much pain you feel. There are many pain scales that include numbers or cartoon faces. Your caregiver may ask you to rate the pain on a scale of 0 to 10.
  
  
• Stimulation tests: Stimulation tests tell exactly which nerves or muscles are affected by pain. These tests may include electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies.

How is chronic pain treated? The aim of chronic pain management is to relieve pain and improve your quality of life. Controlling chronic pain may allow you to work, attend school, or do your usual activities. Caregivers may need to treat the cause of your pain. It is best to work together with your caregiver to decide the pain control treatments that are best for you. You may need one or more of the following:

• Medicines:
  
  
  • Pain medicines: You may be given one or more of the following pain medicines.
    
    
    • Analgesic: This is a group of medicines that includes most painkillers, such as acetaminophen, aspirin, and ibuprofen.
      
      
    • Anesthesia: Anesthesia is numbing medicine to control pain and make you comfortable. This works by blocking pain signals from the nerves.
      
      
    • Opioids or narcotics: These medicines, which include morphine, are used for moderate to severe (very bad) pain.
      
      
    • Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling). Some NSAIDs may also be used to decrease a high body temperature (fever). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
    
    
  • Other medicine: Your caregiver may need to treat the cause of your pain if it is known. Chronic pain caused by infections may be treated with antibiotic or anti-viral medicine to kill the germs. Pain from cancer may be treated with chemotherapy or radiation therapy. Your caregiver may suggest other medicines to help control your pain, or prevent the side (unwanted) effects of pain medicines.
    
    
    • Anti-anxiety medicine: This medicine may be given to help you feel less nervous and more relaxed.
      
      
    • Anticonvulsant medicine: Anticonvulsants are given to control seizures.
      
      
    • Anti-depressants: These medicines may be used to help decrease or prevent the symptoms of severe depression. Anti-depressants improve your mood and treat certain kinds of chronic nerve pain.
      
      
    • Muscle relaxers: This is medicine to help your muscles relax. When your muscles relax, you may move more easily and have less pain.
      
      
    • Sedative: A sedative medicine may be given to help you stay calm and relaxed.
      
      
    • Steroids: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling.
  
  
• Surgery and other procedures: Your caregiver may do surgery to help relieve your pain. He may cut nerves or remove some joints that may be causing your pain. He may use ultrasound, radio waves, thermal (heat), or laser therapy to relieve your pain. Ask your caregiver about these different treatment options for chronic pain.

What are the other ways to treat chronic pain?

• Complementary and alternative therapies:
  
  
  • Acupuncture: Acupuncture is a treatment based on a belief that our bodies have channels through which fluids flow. Caregivers will insert very thin needles just under your skin. This is believed to open the channels allowing fluids to flow better. This treatment may decrease pain and improve healing. Always see a caregiver for this treatment. Do not try to give this treatment to yourself.
    
    
  • Chiropractic therapy: Pain is treated by caregivers who move body parts in certain ways. This may include parts such as the spine (backbone) and joints. Joints are places on the body where two bones meet, such as the elbow, or the knee.
    
    
  • Dietary supplements: Vitamins, minerals, herbs, or other botanicals (plants) may be given to ease chronic pain.
    
    
  • Mind-body therapies:
    
    
    • Biofeedback training: Biofeedback is a special way to control how your body reacts to things like stress or pain. The first step in this training is to use electrodes (wires) to monitor your body responses. These electrodes are placed on different parts of your body, such as your chest. The electrodes are attached to a TV-type monitor which gives a paper tracing of your heart beating. You will learn how to control body changes, such as slowing your heart rate, when you become upset.
      
      
    • Hypnosis: This is done by putting you in a trance (sleep-like) condition. Your caregiver then suggest ways that may help you to heal yourself.
      
      
    • Meditation: This therapy teaches you how to focus inside yourself. The goal of meditation is to help you feel more calm and peaceful.
      
      
    • Relaxation therapy: Relaxation therapy teaches you how to calm your body and mind. The goal is to feel less physical (body) stress and have less emotional (mind) stress.
  
  
• Electrical stimulation: A special device is used that sends mild and safe electrical signals. These signals decrease your pain when used over a painful body part.
  
  
• Heat and cold application: Some types of pain are decreased by using warm or heat packs while others improve with cold. Your caregiver will tell you if warm or cold packs, or both used alternately, will help your pain. Taking a warm bath may also help your muscles relax. A cool shower on a very hot summer day may also relax tense muscles.
  
  
• Rehabilitation: This program may include physical and occupational therapy. In physical therapy (PT), special exercises are made to help your body get stronger and heal faster. Massage and physical therapy can work better if you also use guided imagery, breathing exercises, or music. Occupational therapy (OT) uses work, self-care, and play activities to help you in your daily life. These include special skills for bathing, dressing, cooking, eating, and driving.

What might happen if chronic pain is not treated? Chronic pain may affect many areas of your life. It can affect your appetite (ability or desire to eat), how well you sleep, your energy and your ability to do things. It can also affect your mood (how you feel about things) and your relationships with others. It is sometimes hard to find the cause of chronic pain. You may feel that your pain will never go away. This can cause a cycle of suffering, sleeplessness, and sadness. If caregivers can help control your chronic pain, you may suffer less and enjoy your life more.

Where can I find support and more information? Having chronic pain may be a life-changing condition for you and your family. Accepting that you have chronic pain may be hard. You and those around you may feel sad, frightened, and anxious. These feelings are normal. Talk to your caregiver, family, or friends about your feelings. Contact the following for more information about chronic pain:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• National Chronic Pain Outreach Association
  PO Box 274
  Millboro, VA 24460
  Phone: 1-540-862-9437
  Web Address: www.chronicpain.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Link to this page

Printable Version

Email Page